D. A. Sediq

Effects of lotrafilcon A and omafilcon A bandage contact lenses on visual outcomes after photorefractive keratectomy

PURPOSE: To evaluate postoperative healing between bandage contact lenses with high and low oxygen permeability in patients having photorefractive keratectomy (PRK). SETTING: Center for Refractive Surgery, Walter Reed Army Medical Center, Washington, DC, USA. METHODS: This retrospective study compared patients receiving a high‐oxygen‐transmission bandage contact lens (Focus Night & Day [N&D], Ciba Vision; n = 92) and those receiving a low‐oxygen‐transmission lens (Proclear, Cooper Vision; n = 114) after PRK. Visual outcomes, safety, and efficacy were assessed postoperatively at 1, 4, and 7 days and 1, 3, 6, and 12 months. RESULTS: Overall pain scores were higher in the Proclear group at 1 day (P = .000) and 4 days (P = .027). The N&D group had an increase in corneal infiltrates at 4 days (P = .025) and 1 week (P = .017). At 1 month, 40.4% of patients in the Proclear group and 18.6% in the N&D group had a 1 or more line decrease in best spectacle‐corrected visual acuity (BSCVA) (P = .002). Although there was a trend toward a higher haze rate in the Proclear group, it was not statistically significant (P = .064). There was no statistically significant difference in uncorrected visual acuity, goal of emmetropia, contrast sensitivity, or reepithelialization. CONCLUSIONS: The N&D lens produced less pain and better postoperative results in terms of haze and BSCVA at 1 month. However, it led to a higher incidence of corneal infiltrates. There was no difference between the lenses in the end result at 12 months.

Effect of brimonidine tartrate 0.15% on night-vision difficulty and contrast testing after refractive surgery

PURPOSE: To evaluate the efficacy of brimonidine tartrate ophthalmic solution 0.15% in patients with night‐vision difficulties after laser refractive surgery. SETTING: Center for Refractive Surgery, Walter Reed Army Medical Center, Washington, District of Columbia, USA. METHODS: Six patients with significant night‐vision complaints after refractive surgery were enrolled in this study after other treatable causes of night‐vision difficulty such as residual refractive error and dry eye were excluded. Low‐contrast visual acuity (LCVA) over a range of contrasts (1.25% to 25%) and small letter contrast sensitivity were tested at photopic (100 cd/m2) and mesopic (1 cd/m2) luminance levels, with and without a standard glare source. Testing was performed before brimonidine tartrate ophthalmic solution 0.15% was administered. Measurements were repeated 1 hour and 1 month after the use of brimonidine tartrate. RESULTS: One hour after using brimonidine tartrate 0.15% solution, patients had significant improvement in LCVA, LCVA with glare, and contrast sensitivity. After 1 month of treatment, all 6 patients reported subjective improvement in night vision and there was a significant difference in performance in mesopic LCVA and mesopic LCVA with glare. The mean pupil size before administration of brimonidine tartrate ophthalmic solution 0.15% was 6.44 mm ± 1.11 (SD). Pupil size 1 hour after instillation had decreased to 4.53 ± 1.27 mm and at 1 month had increased to 6.50 ± 0.94 mm. CONCLUSION: Brimonidine tartrate ophthalmic solution 0.15% improved contrast sensitivity and acuity and decreased night‐vision difficulty for up to 1 month in patients with significant complaints after refractive surgery.